NEW YORK (Reuters Health) - A treatment introduced less than
10 years ago has already made a difference in the number of
Americans losing their vision and being admitted to nursing
homes, according to a new study.

Two Duke University economists looked at Medicare
beneficiaries with so-called "wet" macular degeneration and
found those diagnosed after the introduction of anti-VEGF drugs
were less likely to go blind and less likely to move into
long-term care.

"At last we have found a way of managing this horrible and
very common disease among the oldest of the old," said Frank
Sloan, who led the new study.

Age-related macular degeneration (AMD) is the number one
cause of blindness in the U.S. affecting older adults, usually
after age 65. Most AMD patients have the dry form of the
disease, but about 10 percent have wet AMD, which progresses
more quickly than the dry form.

Past treatments weren't very effective at managing wet AMD,
but retinal surgeons began using injections of vascular
endothelial growth factor inhibitors, known as anti-VEGF, in the
mid 2000s.

Previous clinical research has indicated that anti-VEGF
treatments are effective for wet AMD, but Sloan said those types
of studies don't let you see longer-term outcomes or how well
the therapy works in a real-world setting.

The researchers used Medicare claims information from 1994
to 2011 to examine the vision outcomes and long-term care
facility admissions of wet AMD patients who were treated with
older methods or with the new anti-VEGF drugs.

The two most commonly used drugs, ranibizumab (Lucentis) and
bevacizumab (Avastin), were introduced for eye therapy in 2006.

The researchers discovered that the use of anti-VEGF therapy
reduced vision loss by 41 percent and the onset of severe vision
loss and blindness by 46 percent, compared to earlier forms of
treatment.

They also found that patients who received anti-VEGF were 19
percent less likely to be admitted to long-term care facilities
during a two-year follow-up period compared to those treated
before the drugs came into use.

The findings were published in JAMA Ophthalmology.

The new treatments may be changing the way some doctors
think about wet AMD.

"We used to say it was better to have the dry form because
it tended to be milder and slowly progressive as opposed to the
wet AMD, which has a rapid onset and much more severe vision
loss," Dr. Michael Stewart told Reuters Health.

Stewart, who chairs the ophthalmology department at the Mayo
Clinic in Jacksonville, Florida, was not involved in the new
study.

Stewart said results like these actually call into question
whether or not that old statement is still true because the
anti-VEGF drugs are so effective.

"By and large, we are maintaining good vision in most people
that we treat," Stewart said.

Stewart also says the new drugs have revolutionized the way
retinal surgeons approach these patients.

He says that early diagnosis with quick initiation of
treatment is the best way of preserving vision. The typical
course of treatment is to give an injection of the drug in to
the eye, about one time per month, but treatment can be tapered
to the patients' needs.

"Patients and family - and most of us, actually - think of a
needle in the eye as one of the worst medical procedures we can
imagine," Stewart said, "but the reality is patients tolerate
them very, very well and very few patients actually forgo the
treatment because of either imagined or real pain, discomfort
and anxiety."